Intermenstrual bleeding according to Chinese Medicine

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Metrorrhagia, Bleeding between periods and Mid-cycle bleeding redirect here

Intermenstrual bleeding factsheet

Chinese name: 经间期出血

Pinyin name: Jīng Jiān Qí Chū Xiě

Possible causes and remedies:

In Western Medicine, intermenstrual bleeding is called metrorrhagia. Bleeding between menstruations is characterized by an extra bleeding session happening around mid-cycle time when ovulation occurs. It normally doesn't exceed two days and the quantity of blood can be scanty or profuse.

Sometimes it can be mistaken as early menstruation if the bleeding is comparatively heavy and lasts longer than 2 days, which can occur. It should also be distinguished from abnormal uterine bleeding or excessive red vaginal discharge

According to Chinese Medicine the Directing and Penetrating Vessels control ovulation under the influence of Kidney Yin and Yang. A malfunction of the Kidneys is therefore typically responsible for this unwanted bleeding during ovulation time, even though other patterns might also play a role as we'll see. 

As you can see below we've detailed for you the four "patterns of disharmony" associated with intermenstrual bleeding. Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted. It is not equivalent to a Western condition, as a matter of fact here intermenstrual bleeding can be explained by four different patterns.

Each of those patterns can be treated with one or several herbal formulas. Drinking herbal infusions is the most common remedy in Chinese Medicine, together with acupuncture. It is the Chinese Medicine equivalent to drugs, apart that it's 100% natural!

In total we detail below seven formulas that can help treat the various patterns that cause intermenstrual bleeding, depending on which pattern fits your profile.

The four "patterns of disharmony" associated with intermenstrual bleeding

Unprepared Rehmannia (Di Huang) is the key herb for Zhu Yu Zhi Xue Tang, a formula used for Blood Stagnation

Blood Stagnation

Pulse type(s): Wiry (Xian)

Tongue color: Purple in the centre

Recommended herbal formula: Zhu Yu Zhi Xue Tang

Symptoms: Restlessness Abdominal pain Dark colored blood Dark clots in menstrual blood

The main symptom under this Blood Stagnation pattern is the dark clots and dark color menstruation blood. The bleeding can be scanty or heavy. 

The Stagnation can be caused by birth-giving, abdominal surgery or traumas. It can block the Directing and Penetrating Vessels as well as the Uterus, thus any newly created Blood has no place to go but spill out unwantedly during mid-cycle.

The treatment principle is to invigorate Qi and Blood, remove Stagnation and stop bleeding.

Read more about Blood Stagnation here

Chinese Pink Herbs (Qu Mai) is the key herb for Ba Zheng San, a formula used for Damp-Heat

Damp-Heat

Pulse type(s): Slippery (Hua)

Tongue coating: Sticky coating, Yellow coating

Tongue color: Red

Recommended herbal formula: Ba Zheng San

Symptoms: Fatigue Joint pain Poor appetite Chest pressure Vaginal discharge Scanty and dark urine

Mid-cycle bleeding under this pattern can be recognized by the sticky texture of the blood, without clots. Blood volume can be scanty or heavy. 

The Spleen is the main Organ involved. When the Spleen is weak, it fails to perform properly its function of transforming and transporting Body Fluids. Therefore Dampness accumulates and it also create Heat or Fire. The Damp Heat not only harms the Directing and Penetrating Vessels but also provokes the Blood and cause bleeding during mid-cycle. The Liver is another organ involved because it stores the Blood. 

Irregular diet is responsible for weakened Spleen function, such as excessive consumption of dairy or greasy foods. The treatment principle is to clear the Liver, fortify the Spleen, remove Dampness and stop bleeding. 

Read more about Damp-Heat here

The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine

Kidney and Liver Yin Deficiency causing Heat in the Blood

Pulse type(s): Rapid (Shu), Empty (Xu), Fine (Xi), Floating (Fu)

Tongue coating: Complete absence of coating

Tongue color: Red

Recommended herbal formulas: Liang Di Tang, Er Zhi Wan, Liu Wei Di Huang Wan, Zuo Gui Wan

Symptoms: Tinnitus Dizziness Back pain Dark Urine Night sweats

The mid-cycle bleeding between periods is characterized by scanty and scarlet-red blood. Normally there is no abdominal pain or clots. 

Liver and Kidney Yin can be seriously damaged if a woman works excessively without sufficient and proper rest or gives birth to many children very close to each other. It can lead to Empty Heat in the sense that this Heat exists due to lacking of Yin which is a natural cooling element of the Body. This Heat agitates the Blood and impairs the Directing and Penetrating Vessels, including their ability to control Blood during ovulation. This causes the Blood to leak out unwantedly around mid-cycle. This condition is more common among older women.

The treatment principle is to nourish both Liver and Kidney Yin, clear Empty Heat, strengthen the Directing and Penetrating Vessels and finally try to stop bleeding. It is very important to first address the fundamental reasons of the unwanted mid-cycle bleeding rather than simply trying to stop the bleeding itself.

Read more about Kidney and Liver Yin Deficiency causing Heat in the Blood here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Spleen or Kidney Yang Deficiency

Pulse type(s): Deep (Chen), Weak (Ruo)

Tongue color: Pale

Recommended herbal formula: Gu Ben Zhi Beng Tang

Symptoms: Tinnitus Dizziness Back pain Knee pain Tiredness Depression Loose stools Feeling of cold Frequent urination

Mid-cycle bleeding under this pattern is characterized by red color menstruating Blood without clots. Normally there is no abdominal pain and the volume can be scanty or heavy. 

The Kidneys store the Essence and the Spleen controls the Blood. When these two Organs' Yang is Deficient, no sufficient Qi, which is a Yang element, is created to hold Blood in its vessels. It also injures the Directing and Penetrating Vessels. Thus unwanted bleeding is the result. 

Excessive physical activities, from work or sports, can harm the Kidneys and the Spleen and cause Yang Deficiency in the Lower Burner. It can lead to Cold in the Uterus. The treatment principle is to strengthen the Spleen and Kidneys, tonify Yang, warm the Uterus and contain Blood.

Read more about Spleen or Kidney Yang Deficiency here

The seven herbal formulas that might help with intermenstrual bleeding

Zhu Yu Zhi Xue Tang

Source date: 1826 AD

Number of ingredients: 8 herbs

Key actions: Invigorates Blood. Stops bleeding.

Why might Zhu Yu Zhi Xue Tang help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Blood Stagnation, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Blood Stagnation, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Zhu Yu Zhi Xue Tang here

Ba Zheng San

Source date: 1107 AD

Number of ingredients: 9 herbs

Key actions: Clears Heat and Fire. Promotes urination. Unblocks painful urinary dribbling.

Why might Ba Zheng San help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Damp-Heat, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Damp-Heat, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Ba Zheng San here

Liang Di Tang

Source date: 1826 AD

Number of ingredients: 6 herbs

Key actions: Nourishes Yin. Cools Blood. Stop bleeding.

Why might Liang Di Tang help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency causing Heat in the Blood, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Kidney and Liver Yin Deficiency causing Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Liang Di Tang here

Gu Ben Zhi Beng Tang

Source date: 1826 AD

Number of ingredients: 6 herbs

Key actions: Tonifies Qi and Yang.

Why might Gu Ben Zhi Beng Tang help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Spleen or Kidney Yang Deficiency, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Spleen or Kidney Yang Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Gu Ben Zhi Beng Tang here

Er Zhi Wan

Source date: 1534 AD

Number of ingredients: 2 herbs

Key actions: Nourishes Liver Yin. Nourishes Kidney Yin.

Why might Er Zhi Wan help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency causing Heat in the Blood, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Kidney and Liver Yin Deficiency causing Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Er Zhi Wan here

Liu Wei Di Huang Wan

Source date: 1119 AD

Number of ingredients: 6 herbs

Key actions: Nutritive tonic for the Liver and Kidney Yin Essence (nourishes the parasympathetic nervous system).

Why might Liu Wei Di Huang Wan help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency causing Heat in the Blood, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Kidney and Liver Yin Deficiency causing Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Liu Wei Di Huang Wan here

Zuo Gui Wan

Source date: 1624 AD

Number of ingredients: 8 herbs

Key actions: Nourishes the Yin. Strengthens the Kidneys. Fills the Essence. Augments the marrow.

Why might Zuo Gui Wan help with intermenstrual bleeding?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency causing Heat in the Blood, a pattern sometimes associated with intermenstrual bleeding. If it looks like you might suffer from Kidney and Liver Yin Deficiency causing Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Zuo Gui Wan here